Doctor getting kickbacks?

 

I am contemplating surgery. I have a surgeon that uses one of
the outpatient surgery centers to do his work and he
typically does thousands of the same operation a year at this
same place.

I have reason to think he maybe have a financial interest if
not outright getting kickbacks from this surgery center and
he is very closed about disclosing costs associated with
surgery.

Is there a way, short of taking him to court that I can
determine if he has a financial interest in this center where
he does his cutting?

 

peewee wrote:

I have a suggestion.  Ask him if he has a different recommendation of
where to have the surgery done and why he chooses that one center, and
if he had a second preference if you could not get your surgery done
there, who would he recommend.

Alternatively, call the surgery center and ask them if the doctor has a
financial interest in it because you are personally opposed to having
surgery there if he is getting a kickback.

He may prefer that center because they are easier to work with, because
it takes the largest variety of insurance plans, or a whole myriad of
other perfectly valid and reasonable reasons.

The physician I worked for did the vast preponderance of procedures at
one outpatient surgery center because they never gave him a hard time
about scheduling, they always had the right equipment there for the
procedures he needed to do, etc.  And he did a lot of workers' comp
procedures there, and worker's comp guidelines generally state that a
physician cannot do surgery on a workers' comp patient at a facility
where the physician has a financial interest.  He did have three or four
other locations that he had privileges at and would do procedures at if
he had to, and he might have had a vested interest in one or more of
them, but he did not prefer to use them, usually for reasons like they
didn't have the equipment that he needed to do the procedures (even
though he gave them a list, and one time he didn't find this out until
he had already started and had to make do with something else), they
would cancel blocks of time he had reserved without letting him know,
the facility had a poor track record of getting insurance to pay for the
procedures that were covered by the patient's insurance policy, etc.

 

On 4/14/2010 2:56 PM, peewee wrote:

It varies by state.  Some states require the doctor to tell you if he
holds a financial interest in the surgery center.

Kickbacks are usually illegal.  Holding a financial interest in the
facility is not.

You might ask the doctor what his second choice of location for the
surgery is.

 

1rWnZ2dnUVZ_tadnZ2d@posted.southvalleyinternet:


you if he

interest in the

for the

"h" and "Bill" are the same person posting under different
IDs-look at their news reader clients and other info.

Most of the replies, except yours, are most likely people in
the medical field or those representing them.

It is illegal not to disclose a financial interest in a third
party facility in my state. Any doctor who does this is
unprofessional and more a businessman than a doctor.

The fact that a doctor will not disclose costs is sufficient
in my opinion to deny him a license to practice medicine.
These are people, not Gods, they are not allowed to play
under a different set of rules than the rest of us. Not
disclosing costs is dishonest, plain and simple.

 


Well, as someone who has worked in the medical field for 18 years, how
much it costs truly depends on what insurance the patient has, assuming
that the patient wants to know how much it will cost him/her.  And even
if the insurance company gives you an estimate of the costs up-front,
that doesn't mean that even if they approve the surgery they won't come
back after the fact when you submit the claim for it and say, "Sorry,
we're not paying for that," and there is not a whole bunch the doc can
do except appeal the claim denial and see if he can convince the
insurance company to pay for it -- which, if they won't, will mean that
the patient now will have to pay a lot more to cover what the insurance
company reneged on.